title: Assessing communication skills in dietetic consultations: the development of the reliable and valid DIET-COMMS tool.
abstract: BACKGROUND
  There is an increasing emphasis on the development of communication skills for dietitians but few evidence-based assessment tools available. The present study aimed to develop a dietetic-specific, short, reliable and valid assessment tool for measuring communication skills in patient consultations: DIET-COMMS.
  
  
  METHODS
  A literature review and feedback from 15 qualified dietitians were used to establish face and content validity during the development of DIET-COMMS. In total, 113 dietetic students and qualified dietitians were video-recorded undertaking mock consultations, assessed using DIET-COMMS by the lead author, and used to establish intra-rater reliability, as well as construct and predictive validity. Twenty recorded consultations were reassessed by nine qualified dietitians to assess inter-rater reliability: eight of these assessors were interviewed to determine user evaluation.
  
  
  RESULTS
  Significant improvements in DIET-COMMS scores were achieved as students and qualified staff progressed through their training and gained experience, demonstrating construct validity, and also by qualified staff attending a training course, indicating predictive validity (P < 0.05). An acceptable level of intra-rater reliability (rs  = 0.90) and a moderate level of inter-rater reliability (r = 0.49) were demonstrated. Interviews identified many positive features and possible uses for DIET-COMMS in both pre- and post-registration settings. The need for assessor training was emphasised and how readily qualified dietitians would accept assessment of skills in practice was questioned.
  
  
  CONCLUSIONS
  DIET-COMMS is a short, user-friendly, reliable and valid tool for measuring communication skills in patient consultations with both pre- and post-registration dietitians. Additional work is required to develop a training package for assessors and to identify how DIET-COMMS assessment can acceptably be incorporated into practice.
authors.affiliation: School of Biosciences, Division of Nutritional Sciences, Loughborough, UK.
authors.forename: K A
authors.initials: KA
authors.lastname: Whitehead
authors.forename: S C
authors.initials: SC
authors.lastname: Langley-Evans
authors.forename: V A
authors.initials: VA
authors.lastname: Tischler
authors.forename: J A
authors.initials: JA
authors.lastname: Swift
mesh_terms: D003142:Communication; D004032:Diet; D004046:Dietetics / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D064686:Nutritionists / Q000193:education*; D011594:Psychometrics / Q000193:education; D012017:Referral and Consultation; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: assessment tool; communication skills; consultation; dietitian; psychometric